Individual provider Active NPI

Aimee Coughlin Johnson, LCSW

  • Social Worker
  • Portland, OR
National Provider Identifier
1891990388
Registry record updated Oct 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
3852 Issued in OR
Practice address
5819 N. Greeley Avenue
Suite 102
Portland, OR 97217
Phone
(503) 295-7337
Fax
(509) 926-9161
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3852 OR
Social Worker 104100000X 3852 OR Primary

Addresses

Primary practice location

5819 N. Greeley Avenue
Suite 102
Portland, OR 97217

Mailing address

5819 N. Greeley Avenue
Suite 102
Portland, OR 97217
Phone (503) 295-7337

Other names 1

  • Ms. Aimee Coughlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3852ORMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1891990388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 N. GREELEY AVENUE",
            "address_2": "SUITE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97217",
            "telephone_number": "503-295-7337",
            "fax_number": "509-926-9161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 N. GREELEY AVENUE",
            "address_2": "SUITE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97217",
            "telephone_number": "503-295-7337",
            "fax_number": "509-926-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AIMEE",
        "middle_name": "COUGHLIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3852",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "3852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AIMEE",
            "last_name": "COUGHLIN",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.